Individual
MR. JEFFREY G KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
211 VIRGINIA AVENUE, PETERSBURG, WV 26847
(304) 257-1759
(304) 257-1759
Mailing address
211 VIRGINIA AVENUE, PETERSBURG, WV 26847
(304) 257-1759
(304) 257-1759
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
WV3430
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7800023000
—
WV
Enumeration date
12/04/2006
Last updated
07/08/2007
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